3088 - Laserfiche WebLink

Home Browse Search

.P�GC�IPermit o. 8 APPLICATION FOR SANITATION PERMIT (Complete in Duplicate) Date Issued -�- I Application is hereby made to the San Joaquin Local Health District for a permit to construct and install the work herein described. This application is made in compliance with County Ordinance No. 549. . . --------------------------------------------------------- 3 JOB ADDRESS AND LOCATION.._.-�- k_____ -----� ----------------- ------- Phone--------------�-�✓�-----••---- Owner s Name-----------------------------•--•---- _aC.1?. �n- -------Z------ a �Address---------•--------•------- ------------------- ------ Phone-----c' ------ Contractor's ----Contractor s Name---------------------------- Installation will serve: Residence * Apartment House El Commercial ❑ Trailer Court ❑ Motel Other ❑ ;, "r 6 `-------------------- i Number of living units: _-____- Number of bedrooms _____ -- Number of"baths -/---- Lot s'sze --------------- --------- Water Supply: Public system ❑ Community system ElPrivate E] Depth to Water Table -------- ft. Character of soil to a depth of 3 feet: Sand E] Gravel ❑ Sandy Loam [_1 Clay Loam El Clay ❑ Adobe ❑ Hardpan ❑ r. Previous Application Made: Yes ❑ No ❑ New Construction: Yes ❑ No ❑ 4 TYPE'OF INSTALLATION AND SPECIFICATIONS: (No septic-tank or cesspool permitted if public sewer is available within 200 feet.) tic Tank; Distance from nearest well__--___________Distance from foundation __________Ma+erial_-__________-_-______--___________:____________. s No. of compartments Liquid depth ------Capacity-----------s.,-=-------- 4 7 p Size q p -- ,.. < --_,__.__Distance to nearest lot line- --__--_---- Disposal Field: Distance from'nearest wellOrr__Distance from foundation) Number of lines_______:__ ------------Length of each line__�p-----Sb_'Width of trench---` -��------- Type of filter material---�___�__..________-Depth of filter material___)- --------=---Total length___. . -- r Seepage Pit: Distance to nearest well_.___--_________-.___Distance from foundation--------------------Distance to nearest lot line____-____--_-_-. S` --- ---•----- ❑ Number of pifis----------------------Lining material-----------------------Size: Diameter----------------------Depth--------------- .. ' Cesspool: Distance from nearest well-----------------Distance from foundation----_--------------Lining material------------------------------•T1s. 4� Y ❑ Size: Diameter--------------------------------------Depth--------------------- -----------------------_-- Liquid Capacity 9 ______Distance from nearest buildin ----------- "1 Privy: Distance from nearest well_______________----------- -- ------ - - g ------ � El Distance to nearest lot line r Remodeling and/or repairing (describe)------------------------------------------------ •---• a --------------------------------------------------------------- --------------------------------------- -----------------------------------------------•-----.--- A .----------------------------------------------------------------------------------------- -------_-------------------------_____________________________________________________________________________-_____________________ I hereby certify will be done in accordance with San Joaquin County At I have prepared thi lira+ion and that the work ordinances, tate law , nd rules a d ' regal +'ons of the n Joaquin Local Health District. ar Contractor) 3 (Signed)------ -----y�-t----• - -- -'¢"�-- -- -- -----�- - -- --- ----------- ----------- -------- --------- -- -------- - [Plat PI , show' g size of t"ca—+ ofsy em in relation to wells, buildings, etc., can be aced on reverse side}. I FOR DEPARTMENT USE ONLY DATE--- ------------- w APPLICATION ACCEPTED Bl�-------------------------------------------------------------------------- -------------- DATE_--------------------------------------------------- -- - --- -----------------------------------------------------REVIEWED BY----------------------------- - --- -------------- - -- r. BUILDING PERMIT ISSUED------------ - -------------------------------------------- § Alterations and/or recommendations:----------_---------------------- -------------------------.-------------------------------------------------------------- FINAL INSPECTION BY:--- - � ------------------------------------- SAN JOAQUIN LOCAL HEALTH DISTRICT 300 West Oak Street 132 Sycamore Street 814 North "C" Street 130 South American Street � Trac California Stockton, California Lodi, California Manteca, California y, � r ES-9-2M 8-SI Revised W-2100 _